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Bermuda's Hospitals and Brown-Darrell Stem Cell Clinic

Taxpayer-financed with employers and employees also paying a mandatory hefty monthly healthcare insurance premium

By Keith Archibald Forbes (see About Us) exclusively for Bermuda Online

To refer by e-mail to this file use "bermuda-online.org/kemh" as your Subject

See also Bermuda's Health Support Groups by the same author.

History of hospitals in Bermuda

1812. 1st Hospital. Royal Navy. Admiralty House, Long gone.

1818. Construction of the RN Hospital near the Dockyard, in the same pre-fabricated manner as the Commissioner's House. In addition to cast iron structural features, such as veranda columns, floor joists, and possibly cast and wrought iron roof trusses, some of the stonework for the building was the hard local limestone. During World War 2, it treated and often saved the lives of many brought in from torpedoed ships.  Royal Navy left in 1950s. That great building ended its life as an egg farm, then finally was deliberately burnt to the ground by the Fire Department in November 1972. Part of it became the site for Lefroy House, for senior citizens.

1841. Planning of first Bermuda civilian hospital. On 28 April, the Bermuda Legislature passed an "Act for the Safe Custody of Insane Persons charged with Offences. " It was the first local legislation to deal specifically with persons with mental problems. Persons charged, if found to be insane, were kept in custody until they could be sent to an asylum. In 1846, a further Act was passed to establish a hospital for the reception of "insane paupers." It enabled the Governor, Lieutenant Colonel William Reid, to buy land in a central parish for an asylum. Moved to and see under "St. Brendan's Hospital" in Devonshire Parish.

1848. Opening of first Bermuda civilian hospital -  the Lunatic Hospital (as it was then called, insensitively). Dr. Henry Josephus Hinson, a graduate of Edinburgh Medical School in Scotland, was the first medical superintendent. It remained in its original location for 22 years.

1864. A Board of Health hospital was established at Cedar Hill, St. George's, for victims of the Yellow Fever epidemic then raging in Bermuda.

1868. Re-location and expansion of former Lunatic Hospital, now St. Brendan's. It moved to its present location, the site of the former Devonshire College. Later, under Governor General Sir John Lefroy, the Devonshire College buildings were expanded after he convinced Parliament to spend £3,650 sterling to pay for additional work. A much larger facility was required from the beginning of the 20th century, especially during and after the two world wars. St. Brendan's became its official name, after the Irish saint born about 484 AD.

1850s. 3rd Hospital. British Army, Prospect. Building still there, British Army left in 1950s, continued as Bermuda Government-owned Old Prospect Hospital until 1971/72. No longer a hospital.

1894.  March 11, Hospital Sunday. 4th Hospital. Second civilian hospital. Patients of all classes who required hospital treatment were admitted to the little rectangular structure known as the Cottage Hospital which had only a handful of beds. It was the first civilian (but not military, as there were two) hospital in Bermuda. It was on elevated ground near the east end of Pembroke Parish on the Military Road from Fort Hamilton to Prospect. It subsequently became King Edward VII Memorial Hospital. See below.

1901. Port's Island Hospital for Boer War prisoners-of-war. Also used to house 3 German nationals interned and 58 German merchant seamen in the 1914-18 Great War.

1920. The first official Royal Visit to Bermuda was when Albert Edward, Prince of Wales (later, briefly, King Edward VIII) concluded his tour of the British Empire. It was the first of three visits to Bermuda by him. On this first occasion, one of his official duties was the opening of the King Edward VII Memorial Hospital on its present Paget location, formerly the much smaller Cottage Hospital in Paget Parish.

1941. First American hospital facility in Bermuda. American troops at the Castle Harbour Hotel brought with them a medical contingent of eight officers and men and established on a temporary basis on the first floor of the hotel an infirmary, not a hospital.

1941. August. First American Hospital in Bermuda. It was at what was was - is now, again - the Bermuda Biological Station for Research at Ferry Reach. The American Government obtained a lease of the buildings and grounds (with the biologists re-housed at the Government Aquarium, Flatts). A temporary American military hospital was established there. It was staffed by four physicians, a dentist and nurses, all US Army personnel. It was responsible for all members of the US Army Engineers and the thousands of workers involved in the building of the Fort Bell/Kindley Field Base.

1941. September. US Navy began construction of an Annex Clinic at the first US Armed Forces Base in Bermuda, in Southampton Parish. In 1993, it was closed and amalgamated with the Base Clinic at USNAS, St. David's.

1941. October. Work was begun by US Army Engineers on the building of an elaborate 150-bed permanent hospital at Fort Bell. It is no longer there but on the same site on which the present, much-newer, former US military hospital - but now abandoned, vandalized and vacant - now stands.

1942. When the Riddell's Bay Golf Club was a US Navy recreation centre during the war, a mobile hospital for the war-wounded was established nearby. It too saved the lives of many brought in from torpedoed ships. Others were brought in to the Royal Navy Hospital just outside Dockyard (now Lefroy House).

1943. May. The first US Military base hospital at Fort Bell was finally completed, but only with the bare essentials, notwithstanding its price-tag to US taxpayers of more than $1 million. But there were sufficient facilities at the new site to justify giving plenty of notice in advance of the closure of the infirmary at the Castle Harbour Hotel and the temporary hospital located at the Bermuda Biological Station.

1943. December 30. With completion of the first purpose-built hospital at Kindley Air Force Base (KAFB), Bermuda, the infirmary that had been established at the Castle Harbour Hotel was finally closed out and the hospital facility that had been in operation at the Bermuda Biological Station was also shut down.

1954. It was resolved by the US Military in Bermuda that the base hospital had to be demolished and re-built from scratch at US taxpayers expense again as it had become too much of a liability. Over time, it had been established its beams, concrete and other structures were riddled with rust and related problems, apparently with sea water instead of fresh water used for building, using shoddy construction techniques.

1956. June 21, 1956. Kindley Air Force Base (KAFB), Bermuda celebrated a major event, with Bermudian help. The occasion was the official dedication of the brand-new base hospital up to latest US hospital standards, on the site of the old building which had been demolished because it had incurred some major building errors and its foundations and walls were doomed. Its use was confined to civilian and military employees and personnel of the US Military Forces in Bermuda and their military colleagues at the British and Canadian bases in Bermuda. It was designated as the 1604th Hospital (and stayed that way until 1967 when it was downgraded to a dispensary). Vanguard Construction of the USA built the new building, at a cost to US taxpayers of more than US$1,500,000. It had taken almost two years to build, mostly with Bermudian labor, with the complete interior decoration work undertaken by the Front Street, Hamilton firm of A. S. Cooper & Sons Ltd. The grand opening, held under sunny skies outside the hospital's main entrance, was attended by His Excellency, Governor Sir John Woodall; a delegation from the USA including Dr. Frank B. Berry, then Assistant Secretary of Defense (Health and Medical); Major General W. H. Powell, Jr., Deputy Surgeon General, United States Air Force; and the Honorable J. B. Pine, the United States Attorney General. Also in attendance were the Hon. Sir John Cox, then the Speaker of the Bermuda House of Assembly, the Venerable Archdeacon Stowe, who performed the Invocation and the Right Reverend Robert S. Dehler, Roman Catholic Bishop of Bermuda, who performed the Benediction.

1965. June. King Edward VII Memorial Hospital (KEMH) present building was completed (added to greatly since).

1970. Bermuda Hospitals Board (BHB) established. It brought King Edward VII Memorial Hospital and slightly re-named St. Brendan's Psychiatric Hospital under one governing body. Today, both are owned and staffed by this specialist agency of the Bermuda Government. See Bermuda Government Boards. Chairman of the BHB is Jonathan Brewin, at phone 298-0191. There is also a Bermuda Hospitals Charitable Trust (BHCT), shown in Associations in Bermuda, B Listing. More than 1,500 staff are employed by the two hospitals.

1971. Patients were transferred from old Prospect Hospital to newly opened Geriatric and Rehabilitation Unit at KEMH.

1995. When US Forces quit Bermuda, the former base hospital, by then demoted to a dispensary and Base Clinic, was abandoned too and is still vacant, not used for local social concerns, and vandalized.

1998. Additions to KEMH. They included new Surgical Wing, new Emergency Ward, Hospice, Intensive Care Unit, Pharmacy, etc. plus increased space for many Departments.

2005. 12th May. Mid Atlantic Wellness Institute (MAWI) is the new name and blue is the new colour of St. Brendan's Hospital in Devonshire.

About today's two Bermuda hospitals and services

Bermuda is the only country in the world where the residents and visitors pay not once but three times for hospital and medical services. In the USA, where hospitals are privately financed built and operated, patients pay for all services they use. In Canada, Australia, New Zealand, the UK, Europe, etc. the great majority of hospitals are financed by taxpayers with hospital and medical services included in the taxes paid. But in Bermuda, taxpayers pay three times, first for the building and operating costs as part of their taxes; again in hospital fees and services they use on an as-needed basis; and also in the health or major medical insurances they all must pay by law to either the government or to private and local insurance companies.

   King Edward VII Memorial Hospital (KEMH), the main hospital, is Bermuda Government owned and operated. Point Finger Road, Paget Parish DV 04, Bermuda. Postal address P. O. Box HM 444, Hamilton HM BX. Phone (441) 236-2345. Fax (441) 236-2213. KEMH is operated by the Bermuda Ministry of Health and Family Services, via the Bermuda Government-appointed Bermuda Hospitals Board (BHB), an Associate of the American Hospital Association. It has been accredited since 1972 by Canadian Council on Health Services Accreditation at FLR 4-1730, St. Laurent Boulevard, Ottawa, Ontario, Canada K1G 5LI, telephone (613) 738 3800. 

There is no reciprocal hospitalization or healthcare plan with any other country.

The hospital's current life will come to an end in 2012, and plans to build a new one at the nearby Botanical Gardens were dropped after angry protests last year. The plan now is to rebuild the 40-year-old hospital in phases at the existing site.

Of all the challenges facing healthcare in Bermuda, one of the biggest will be dealing with an ageing hospital which has been the subject of "devastating" reports from independent consultants. Recent report into the health condition of KEMH have been by experts from Johns Hopkins Medicine International and management consultants Kurron Shares, both of the USA.

In the event of an emergency air evacuation from Bermuda to the USA or Canada, for medical services that cannot be performed in Bermuda, Bermuda Air Medivac Ltd is the operator of Bermuda's only emergency aircraft. A well-known philanthropist, David Barber, donated $2 million in 2005, in memory of his wife Mary, to buy an 11-seater jet for the company. Before the initiative, those critically injured or seriously ill had to wait for air ambulances based in the United States and Canada to fly to Bermuda and transport them off the Island.

Senior Bermuda Government appointed officials and paid by the Ministry of Health and Family Services include - from left to right in photo - Chief Medical Officer Dr. John Cann, Bermuda Health Council CEO Anthony Richardson, Bermuda Hospitals Board (BHB) chairman Edwin Wilson, Health Minister Nelson Bascome, BHB CEO David Hill and deputy BHB CEO Venetta Symonds. For details of the various Bermuda medical boards or organizations, please refer directly to them.

Mid Atlantic Wellness Institute (Formerly St. Brendan's Hospital). 44 Devon Spring Road, Devonshire FL01. P. O. Box DV 501, Devonshire DV BX. Phone (441) 236-3770, fax (441) 235-9383. E-mail executive.office@bermudahospitals.bm. Also Bermuda Government owned and operated.

Staff at the two hospitals number over 1500. The switchboard of the main hospital is operated by volunteers of the Hospitals Auxiliary of Bermuda (HAB), Registered Charity 014, from 9 am to 8 pm daily. Its Pink Ladies, Candy Stripers and Pink Men supply volunteer service in the welfare of patients.  They also staff The Barn thrift shop in Devonshire, Pink Cafe and Gift Shop at the hospital.  Visitors should note There is no e-mail address at present specifically to reach patients. But some patients can be reached by telephone. In the best interests of patients, they - not the hospital - should give their hospital phone numbers to their families and friends. Cable TV is available to patients, as an optional extra. 

There is no equivalent in Bermuda now or planned of the Health Insurance Portability Act (HIPAA) 1996 which came into full force and effect in the USA and the US Virgin Islands and other US territories on April 14, 2003. Thus no one in Bermuda is HIPAA compliant.

• Angiography services.
• Cardiac Diagnostic Unit. With a Cardiac Rehabilitation Specialist and Personal Cardiac Patient Folders of cardiac condition, family information, prescriptions, etc. It opened officially in August 2002. Patients undertake a stress test on a unit under the supervision of their doctor. The unit is good but there is no cardio-pulmonary rehab unit and patients are expected to start an exercise programme that is not professionally supervised.
• Heart Defibrillators. Nine were recently donated to the hospital by Australian millionaire resident Bruce Gordon, who also supplied many others island-wide.
• Child's wagons. To transport children to the surgery room, to make the experience less traumatic. Donated by the Continental Society of Bermuda, a registered charity. 
• Diabetes. It has a center devoted to this. But it has limitations. There is also an asthma centre with the use of an office three days a week in the diabetes centre, but the diabetes centre needs this space back. The diabetes centre has a staff of two dietitians and two nurses and there is not adequate space to deliver optimum counseling services.
• Detoxification unit, 8-bed. At the Turning Point Center at St. Brendan's.
• Dialysis unit, new. Renamed and upgraded as the Dr. Beresford Swan Dialysis Centre, named after the local cardiologist who initiated it. But it is already in dire need of more space and, better facilities for the patients who benefit from their services.
• Digital UHF Telemetry Machine, at three stations in Cooper, Curtis and ICU wards. It enables patients to be monitored appropriately.
• Hyperbaric chamber. Thanks to the local diving community.  They raised $250,000 for the new chamber which seats nine persons. It has also helped diabetics.
• Image Analysis Machine, as a diagnostic addition/extension of the Stress and ECG tests.
• Magnetic Resonance Imaging (MRI) Department. New in 2003. It complements CAT examinations. It costs Bermuda taxpayers more than US$1.5 million. MRI result times have been slashed from 2 weeks to 2 days thanks to new digital technology. It is no longer required to send up to 20 pages of scanned images by courier to Johns Hopkins Hospital in Baltimore, for a report to be sent back by e-mail.
• Public Health Act 1949 was amended on November 9, 2001 to ensure the regulation of businesses that practice tattooing, electrolysis and body-piercing.
• Radiology. KEMH paid $300,000 for a radiology information system from Arizona-based Misys Healthcare Systems to make film unnecessary. All X-rays and cat scans now go directly to a computer.
• Ultrasound. A new Sonosite portable unit was imported in April 2002, especially for difficult pregnancies, thanks to a private donation by 7-year residents Mark and Rebecca Byrne.
• From 2005, a 6-8 bed Rehabilitation Unit for some stroke and non-stroke patients. It will not contain any acute care beds as patients who incur very serious life-threatening problems who have insurance or the means will continue to be sent to Johns Hopkins in Baltimore, Maryland or Lahey or Spaulding in Boston, Massachusetts, by air-ambulance, if needed.
• A new morgue. Badly needed.

Not at the hospitals

• No central disease-management program common to the most widely affected problems such as diabetes, heart , stroke and dialysis.
• No hospital- based outpatient pharmacy.  Badly needed. A recent public service survey identified the need for more affordable drugs, especially for the elderly, with chronic diseases and on multiple medications. 
• No podiatry unit within the hospital offering preventative foot care.
• No smoking cessation programme.
• No COPD.

Registration required for all newcomers and locals

This applies to Medicine and Professions supplementary to Medicine. Also, in addition to whatever registration employees are required to have to obtain or retain their accreditation overseas, registration in Bermuda in the appropriate discipline must be obtained before practice is permitted locally, whether at the Bermuda Government-owned hospitals hospitals or in private practice. This applies to a wide range of specialists including Addictions Counseling; Audiology; Chiropody; Diagnostic Imaging technology; Dental Hygienists; Dental Practitioners; Dental Technicians; Dietetics; Emergency Medical Technicians; Medical Laboratory technologists; Midwives; Occupational Therapy; Optometrists and Opticians; Pharmacies;

To better regulate health professionals, there are now powers to suspend or bar people for misconduct.
The Professions Supplementary to Medicine Amendment Act 2006 , enacted by the Bermuda legislature, ensures practitioners are competent and stay up to date with the latest techniques and that there are more teeth for dealing with complaints. The primary purpose is to ensure they meet established standards of education, training and professional conduct and are educated about new procedures that come along. Covering such professional categories such as physiotherapist, occupational therapist and diagnostic imaging the Act establishes a Council for Allied Health Professionals to promote patient interests and exercise discipline over practitioners. A Preliminary Proceedings Committee has been set up to investigate complaints – serious complaints will then be referred to a Professional Conduct Committee which can hand out fines of up to $2,000, suspend a person’s registration for a year or even bar them from practising. 

Only persons on their respective registers are recognized to practice in Bermuda. All involved who need or want further details about registration should contact the Administrative Assistant to the Council, Ministry of Health and Family Services, P. O. Box HM 1195, Hamilton or telephone (441) 236-0224 extension 3441.

Bermuda, according to statistics in the Official Gazette, has audiologists, chiropodists, chiropractors, dentists, dental technicians, dieticians, medical doctors. There are also emergency medial technicians, medical laboratory technologists, midwives, nurses with SRN status or equivalent or enrolled, occupational therapists, optometrists and opticians, dispensing opticians, pharmacies, pharmacists, physiotherapists, radiographers and speech-language therapists. Under the Nurses Act 1969, all nurses, whether registered (SRN or equivalent) or enrolled, are required to renew their licenses on an annual basis. The Medical Program at KEMH has an Annual Review and Awards Ceremony, sponsored by the Bermuda-based prominent international corporation Merck Sharpe and Dohme. It provides thousands of dollars a year in awards as part of a commitment to Continuing Medical Education at KEMH. 

All ambulances have automated external defibrillators (AEDs). They are portable devices that under medical supervision deliver a small electrical shock to restore normal heart rhythm during sudden cardiac arrest, a condition that kills countless patients a year. The average survival rate world-wide for sudden cardiac arrest is just 5 percent, but with fast treatment and an AED, there is a greatly improved chance of survival. The operator of an AED turns on the device and places two pads on the victim's chest. The machine assesses whether the heart is "fibrillating" or quivering instead of beating normally. If an abnormality is detected, the AED prompts the user to push a shock button to deliver a shock to the heart. If it does not restore normal rhythm, the unit repeats the process. An AED won't deliver an electrical charge to a person who has simply fainted and does not have fibrillation. Many AEDs have now been imported to Bermuda, thanks to a resident Australian philanthropist. In most countries that have AEDs - but not yet in Bermuda - "Good Samaritan" laws protect people who operate AEDs to treat a cardiac arrest victim.

Registers and/or interested organizations include

Accommodation for doctors and nurses from abroad

Some accommodation is available for incoming non-Bermudian doctors and nurses. Incomers to Bermuda, the second most wealthy place in the world according to the World Bank, should confirm before they sign any contracts that terms and conditions of service generally are comparable and equivalent in accommodation, length of service, upward mobility, salaries, benefits and airfares to those offered in American, Australian, Canadian, Cayman Islands, European and New Zealand hospitals. At all such places abroad, for academically and professionally qualified staff standard attractions and contracts include all local Board of Nursing or MD-certified or equivalent fees paid, accommodation (one-bedroom or more) for up to three months, round-trip air fares once every year or two, transportation for up to three months, good accommodation and living conditions and a sign-on bonus.

Disabled parking at KEMH

KEMH is not a private parking area but a public one coming under the Parking of Vehicles (Designated Areas) Act 1973. There are three specially-marked handicapped spaces. There are some front of the hospital, as hospitals overseas have them, and others in the rear. Unlike in Canada, USA, UK and Europe where spaces are extra wide, they are not here. Many near accidents have been reported of how disabled persons in the rear of the hospital have nearly fallen over the wall. Nor has the hospital acted on repeated requests from a spokesperson of the Bermuda Physically Handicapped Association, to have the signs specifying Disabled Parking by Permit Only. When persons and their caregivers with a current Disabled Person's Badge (DPB) - like the one shown here - try to park there, they find able-bodied people - without a Disabled Person's Badge - parking there. This happens every day.

Brown-Darrell Stem Cell Clinic 

On the Winterhaven Nature Reserve in Smith's Parish is the historic former Winterhaven Farm House, dating from the 18th century, a fine example of traditional Bermudian architecture. It was owned until recently by the Bermuda National Trust but was sold to Bermuda's Premier Dr. The Hon Ewart Brown, MD and is now the Brown-Darrell Clinic, a medical stem cell research centre opened in 2008, involving Dr. Brown, his wife Wanda and Stemedica Cell Technologies, a California-based biotech company. A scanner said to be capable of producing sensational images has been installed there. It is a Siemens Somatom Sensation 64-Slice CT Scanner, with the technology to provide previously unknown sharpness, diagnostic detail and clarity. The Premier says a complete scan takes as little as five minutes, meaning less time and discomfort for patients, faster results for doctors and the ability to avoid more invasive tests if necessary. Stem cell patients are expected to fly into the Island for treatment. Presently, Bermuda has no stem cell regulations. The clinic has previously stated it would welcome and encourage legislation consistent with the international protocol practised by countries engaged in stem cell research.

Costs to Consumers

In March 2008, Bermuda's Members of Parliament approved a 7.5 percent rise in hospital fees for the second year running, under the Bermuda Hospitals Board (Hospital Fees) Regulations 2008 which came into effect on April 1.  to the House of Assembly on Monday evening. The fee increase was recommended by Bermuda Health Council and was partly to enable the Bermuda Hospitals Board (BHB) to pay for the five-year management services contract it entered into with US firm Kurron Shares in 2007. The last increase , also of 7.5%, was a year earlier when it was claimed the rise would give King Edward VII Memorial Hospital greater financial stability and allow it to plan and develop strategies to improve patient care. In 2007 Former Opposition Leader Grant Gibbon said there had been a 70 percent increase in standard premiums in the past five years. and that the Island's health council had been "toothless" in stemming the rise. Overall, with the new fees in 2007, while residents pay a somewhat lower rate than visitors, rates are now about 25% higher than they are in a similar-sized community hospital in the USA

Surgical, medical and dental rates are extra and are covered in the Bermuda Hospitals Board (Medical and Dental Charges) Amendment Order. Non-residents should pay for medical services, then claim on their overseas insurance. Canadians and Britons used to National Health will find local services very costly, sometimes with only a small amount of the total bill in Bermuda paid by the British or Canadian systems. 

Once, the hospital system was private sector. At that time, it was supported by charity with the efforts of visitors like Mark Twain and British Army then in Bermuda. Today, the costs to all who need the hospitals of Bermuda are not included in national direct and indirect taxes as they are in Canada and the United Kingdom. There is no national health plan in Bermuda. Local taxpayers and visitors pay for hospitalization and related services in several concurrent ways: 

• By the Bermuda Government Employment Tax, a percentage of gross salary payable by every local employee and employer. Second, by the insurance premiums all employers and employees pay in mostly private sector health and hospitalization plans.
• By Bermuda Employers, in addition. The Health Insurance Association of Bermuda (HIAB) requires every Bermuda employer, self employed person and non working spouse to be insured for at least the minimum level of health care benefits. Employers may insure these legal obligations either through the Bermuda Government's Department of Social Insurance or with a private insurer if an approved and registered member of HIAB. They  provide coverage for employees, their spouses who are not working and any children, but they usually split the cost with employees. However, there are limitations and exclusions in medical and health coverage. Dental insurance is also a necessity, even though it is optional to employers. Employers are not required to include Major Medical but most international companies with a Bermuda office do, in the best interests of employees and their families.
• When a child has both parents employed at separate places, one employer or the other will provide the coverage. In mid 2000, as part of a series of reforms to the Hospital Insurance Regulations enacted by the Bermuda legislature on March 12, Bermuda taxpayers will now fund services to do home visits by nurses for treatment such as changing colostomy bags, stroke rehabilitation, changing bandages and administering medication.
• By fees visitors pay as non-residents for any services they require.

Health Care and Major Medical insurance 

Prudent visitors will bring spare money in US Dollars, travel insurance and health insurance to cope with possible unexpected problems including accommodation in an emergency medical situation or a death. Visitors from the United Kingdom should note that the National Health Service of the UK does not apply at all in Bermuda. Nor does it have an equivalent. Medical costs here are as high as, often higher than, those in the USA. Affordable accommodation in Bermuda for such emergencies, especially from April to November, is extremely difficult to find. Every week, visitors suffer emergencies. Many say they do not make any contingency or emergency plans. They claim they have no money and no health and travel insurance for unexpected problems. (When locals go the USA and elsewhere, on cruises or by air, they must either have such a plan or be prepared to pay full medical costs themselves).

In Bermuda, There is no insurance coverage for birth control, only for abortions in certain approved circumstances. 

• 1. See Hospitalization and Health Care Support Groups. If you arrive as an employee with any Bermuda-based local or international company, you will need good insurance coverage from day 1 in Bermuda.  Unlike in Canada, UK and Ireland where basic coverage comes with the taxes one pays, there is no National Heath Plan or equivalent in Bermuda. European visitors should not make the mistake of thinking that because Bermuda is British, reciprocal health services for travelers will apply, as they do between the United Kingdom and many other countries both within and outside the European Economic Community. Bermuda is not on the list of countries with reciprocal health care agreements either inside or outside the European Economic Area, as mentioned in the UK Department of Health's booklet "Health Advice for Travellers." It is recommended that before you get to Bermuda, you take out adequate health and major medical insurance coverage. Costs of medical services in Bermuda are now much higher than they are in the USA.
• 2. Newcomers from Britain should be wary of trying to buy medical insurance coverage from a Britain-based or not Bermuda-based insurance company or broker. It could mean partial or more extensive duplication of coverage, in view of (3). 
• 3. Bermuda employers are required by law to provide at least HIP immediately, with Major Medical after the probationary period. The better employers will be more generous, with Major Medical applying immediately. Do not agree a contract with any Bermuda employer that will not give you Major Medical from the day you begin work. If you will be working as a temp with an employment agency, be aware that the law requires your employer to insure you, not the client of your employer if you are not working in your employer's office. Be aware that there are no standard plans or standard premiums, each employer's plan is different, plans cover employees and when applicable an employee's non-working spouse and any children only, not relatives or friends, apply only in Bermuda and increasingly in recent years, cease when you quit employment or retire or reach the age of 65, whichever comes first. 
• 4. International - multinational - insurers with a registered office in Bermuda are not allowed to compete with local companies for any local business including hospital or major-medical plans. Bermuda's health care insurers must be local. They include the three largest private sector insurers - Argus Group, BF&M Insurance Group and Colonial Insurance Company, plus Kitson Benefit Services and British American Insurance Company Ltd.
• 5. Hospital Insurance Plan (HIP). Social Insurance Department, Government Administration Building, 30 Parliament Street, Hamilton HM 12. Phone 295-5151 extension 1146, 1130 or 1137. A basic health insurance plan. If over the age of 65 and uninsured, seniors 64 or older can enroll in this at premiums to them of $173.84 each a month in 2007, if they are no longer covered by employers. It covers 80% of the cost of hospitalization in a public ward in Bermuda but the exclusions are scary - no coverage for doctors visits after the first four, or operations; prescription benefits only up to $1,200 per senior per year. Not covered at all is having  to go overseas to get treatment of a type not offered in Bermuda. Some Bermudians have spent over $100,000 for a 10-day stay at a hospital in  Boston or Baltimore. The monthly premium is over 30% of the average local pensioners Social Security. Many in Bermuda who are not affluent depend solely on their social security and pay rent, have to decide whether to pay for HIP and prescriptions or do without food.

There is no Long Term Health Care Insurance offered at all by local insurance companies and those international insurance companies incorporated in Bermuda offering it in other countries even when their home offices are, for example, in the USA, are not allowed by law  to offer it in Bermuda. Many residents, whose major medical insurance through their employers stops, if they had it at all, when they reach 65, have had to spend many thousands of dollars of their own money overseas, with no insurance. Visitors who come on vacation or to see family or friends should be aware in advance that they are not entitled to any local health insurance employer-provided employee coverage or benefits. Not covered are services like ambulance fees, x-rays, doctors' consultations and reports, etc. Check whether the hospital will recognize any insurance plans not operated in Bermuda. It may do so, up to a point, for people from the USA with Blue Cross and Blue Shield insurance. 

Health report

A recent health report - the Bermuda Government's Adult Wellness Report - showed that

• One in three islanders are obese, caused in part by unsatisfactory working conditions - bad air, excessive heat or cold, poor work space, long periods of standing or sitting - cause stress which leads to drink and drug abuse, heart disease and obesity.

• 12 percent abuse alcohol

• The six most frequent health problems are allergies, asthma, migraine headaches, tension headaches, depression and anemia. (But all this is contradicted by reports showing heart attacks and strokes as leading causes of death)

• Top health concern is AIDS and sexual diseases, with 52 percent tested for HIV. 55 percent say they receive no education or information from their doctor on sexual practices  or family planning.

• 30 percent of adults use prescription medicines every day

• 90 percent of women 40 and over have had a mammogram

• 95 percent of women 40 and over have had a pap smear

• 60 percent of men 40 and over have had a prostate exam

Referrals

Patients who need tests or treatments at bigger facilities beyond Bermuda are first referred by doctors then go by commercial air or air ambulance to hospitals overseas.  If patients are not covered by Major Medical insurance when they are referred to an overseas hospital, they have to bear the costs themselves. It will be very expensive. Such services are not provided under HIP in Bermuda. One overseas hospital is the world famous Johns Hopkins Hospital at 600 N. Wolfe Street, Baltimore, Maryland. Its superb, comprehensive Rehabilitation Center is available six to seven hours a DAY including Saturdays. Others include the Lahey Clinic, Massachusetts General, Brigham and Women's, all in MA; and for cardiovascular, the Washington Medical Center in Washington DC. 

Health related support groups in Bermuda

For people who have to live with disabilities or problems or both, their immediate caregivers and too often for survivors, including family, friends, co-workers or classmates, a strong support network is an essential part of good physical, mental and spiritual health. 

Links overseas